This is a very detailed 15 page report.
The most likely mode of transmission of STEC in the HHS cafeteria was through an
infected food handler. At the time of the investigation a HHS food handler, that worked at both the cold sandwich station, providing garnishes (lettuce and cheese) to the sandwiches, and at the cookie station was confirmed by PCR, to have been intermittently shedding STEC, Shiga toxin 2.
The laboratory was unable to perform a culture of the stool specimen, which is indicative of an insufficient amount of the pathogen present at the time of testing to culture. The food handler denied illness. However, since most infections are self-limiting and most individuals do not seek health care and/or are not tested, and since it has been documented that STEC can be shed for up to 62 days, it is likely that the food handler was previously mildly ill and did not associate that illness with this outbreak investigation. Since shedding of the pathogen declines over time it is not unexpected that a culture could not be performed
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